N262B Midterm Exam | Answered with Explanations When implementing a new, evidence-based infection control regimen, which should constitute the final step in the nurses' EBP? a. calculating the cost savings that will be realized by using the new regimen b. sharing their experience with other heal...
When implementing a new, evidence-based infection control regimen, which should
constitute the final step in the nurses' EBP?
a. calculating the cost savings that will be realized by using the new regimen
b. sharing their experience with other healthcare professional
c. implementing enforcement measures to ensure compliance with the new regimen
d. conducting a meta-analysis of other infection control measures
(Explanation: The final step in the EBP process is dissemination of the outcomes of the
change. Financial considerations & enforcement measure are not components of the
EBP process, and a meta-analysis would have been conducted much earlier in the
process.)
Which of the following is emphasized by the Institute of Medicine's Roundtable on
Evidence-Based medicine?
a. Ensuring that external evidence, rather than internal evidence, is integrated into care
b. Fostering the level of learning that exists in the American healthcare system.
c. Issuing clinical guidelines to ensure best nursing practices
d. comparing the implementation of EBP in the US with that of other Western countries
(Explanation: The Roundtable is charged w accelerating the progress toward a learning
healthcare system, generating new evidence to support which healthcare strategies are
most effective, and improving public health awareness and understanding about EBP.
Comparison w other countries, issuing specific practice guidelines, and denigrating
internal evidence are not components of its role)
In the process of advocating for EBP in the unit guidelines, a nurse has met with
skepticism from other members of the nursing staff, with several stating, "Evidence-
based practice is good in theory, but it's almost impossible to actually search hundreds
of journals & find the evidence." What could the nurse recommend?
a. Self-reflection on the nurses' current practices
b. Accessing the Cochrane Library
c. contacting the clinical nurse educator on the unit
d. beginning with lay publication before progressing to peer-reviewed journals.
(Explanation: Databases such as the Cochrane Library and the National Guideline
Clearinghouse can provide nurses with quick, easily retrievable, systematic reviews,
and evidence-based guidelines to inform their practices. Self-reflection and contact with
,an educator may be useful measures but do not necessarily advance the cause of EBP.
It would be inappropriate to recommend lay publications as a source of evidence.
The primary care provider of a 49 yo male client has examined and briefly explained the
evidence that supports beginning regular digital rectal exams. Which of the following
factors would justify not performing digital rectal exams in this client's care?
a. The client is vehemently opposed to undergoing digital rectal exams
b. clinical practice guidelines for prostate care have not been published
c. the clinician has been unable to find any large RCTs in a literature review
d. the clinician has previously waited until clients are 55 to begin regular digital rectal
exams.
(Explanation: Pt preference, such as opposition to a particular assessment or
intervention, should be implemented in clinical decision making. The lack of a large RCT
or clinical practice guidelines does not independently justify rejecting the assessment.
Likewise, the clinician's previous practice traditions do not provide sound justification.
Which of the following clinical questions demonstrates understanding of and best
exemplifies the PICOT format?
a. what effect does parent's smoking have on the smoking habits of their children, aged
13-16?
b. Among pts w cancer, what role does meditation, as compared with the use of
benzodiazepines, have on anxiety levels during the 7 days following hospital
admission?
c. Among undergrad college students, what is the effectiveness of a sexual health
campaign undertaken during the first 4 weeks of the fall semester as measured by
incidence of new gonorrheal and clamydinl infections reported to the campus med.
center?
d. In clients aged 8-12, is the effectiveness of a pain scale using faces superior to a
numeric rating scale in the ER context?
(Explanation: Only the answer concerning pts w cancer contains the PICOT elements of
Patient population, Intervention or Issue of interest, Comparison intervention or group,
Outcome, and Time frame. The answer concerning smoking lacks and intervention,
comparison, or time frame while the answer concerning undergraduate college students
lacks a comparison. The answer concerning clients aged 8 - 12 lacks a specific
outcome or time frame.
A new administrator for a health clinic is concerned that some treatments are not as
effective as they could be. After conducting a survey among the staff, it is discovered
that the general consensus is the EBP process is not effective. Which of the following
would be the best step for the administrator to do next?
a. Leave the current treatments in place
, b. Present real-case scenarios in which EBP resulted in better care and long-term
results.
c. change one treatment at a time until EBPs are implemented
d. assign small focus groups to research EBP to implement.
(Explanation: Healthcare providers who do not believe EBP results in improved care
and client outcomes need to be exposed to real-case scenarios in which evidence-
based care resulted in better outcomes than care steeped in traditional practices. If the
staff does not believe it will be a benefit, they will not be receptive to the changes or
implement them. Leaving the current treatments in place does not benefit the clients in
the long term.
Which of the following factors provides the most important rationale for the consistent
implementations of EBP?
a. EBP provides for the most cost-effective client care
b. EBP is accessible to all healthcare clinicians
c. EBP provides consistency in care across healthcare settings
d. EBP improves client outcomes
(Explanations: The goal of health care is to improve the lives of the clients by either
helping them maintain good health or helping them heal. While EBP does contribute to
all choices, the most important is to improve client outcome.)
A nursing supervisor is encouraging the increased use of EBP. Part of the plan is to
encourage searching for appropriate reports to reference. This nurse is encouraging
which of the following components of EBP?
a. Patient preference
b. internal evidence
c. external evidence
d External evidence
(Explanation: External evidence refers to the most relevant & best research. Internal
evidence comes from one's own clinical expertise & outcomes of projects that are
conducted by the facility. Pt preference & value is the third component inherent to the
definition of EBP.
Which of the following should occur first in the steps of EBP?
a. conducting an electronic search of the literature and ranking individual sources
b. creating buy-in from the other clinicians who provide care at the facility
c. Developing an inquisitive & curious mindset
d. assessing whether the practices in question may, in fact, be evidence based
(Explanation: Step 1 in the process when someone develops an inquisitive and curious
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